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Improving Quality at The End of life for Those Receiving Nursing Home Care

Improving Quality at The End of life for Those Receiving Nursing Home Care. Dr Helen Hibbs BM BS MRCGP. Of those resident in nursing homes only 17% die there: DH Data 2008 Quality of end of life care in nursing homes is variable

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Improving Quality at The End of life for Those Receiving Nursing Home Care

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  1. Improving Quality at The End of life for Those Receiving Nursing Home Care Dr Helen Hibbs BM BS MRCGP

  2. Of those resident in nursing homes only 17% die there: DH Data 2008 • Quality of end of life care in nursing homes is variable • 34 % of hospital admissions from nursing homes over 12 months were for conditions which could be treated at home

  3. Staff in nursing homes are not adequately trained or supported to provide high quality end of life care to their frail elderly residents.

  4. Quality of end of life care in nursing homes will be considerably improved, Improving staff satisfaction and the patient and their relatives experience

  5. Root Cause Analysis Deskilled nursing staff Inappropriate medication/lack of medication review Lack of discussion with service users and relatives before crisis point Lack of medical support out of hours The fear factor

  6. Strategy Executive level ownership Stakeholder engagement Followed by Structured education plan 24/7 Medical support Enhanced nursing support

  7. Implementation Plan • Executive ownership • Led By Development and Delivery Group • Meet with care home managers Bi monthly • Meet with Providers As required • Arrange Compton Hospice to deliver education in care homes April 2013

  8. Implementation plan • District nursing specification reviewed by Clinical and commissioning team July 2013 • Arrange Training Session for GPs September 2013 • New GP enhanced service to improve medical cover to nursing homes October 2013 • Re procure GP out of hours service September 2014

  9. Evaluation Plan Record of Number of staff attending training from each care home Evaluation questionnaire sent to nursing homes to look at place of death, staff satisfaction levels and where possible relatives satisfaction levels, post bereavement

  10. Learning Points Leadership needs to be clear and provide energy Leaders need to be able to unblock as appropriate Listening is key: Listen to those with concerns Freeing people up to be empowered All the organisations have their own agendas to consider

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